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PAOO – Periodontally Accelerated Osteogenic Orthodontics

PAOO, Periodontally Accelerated Osteogenic Orthodontics, is an advanced technique that combines a minor periodontal procedure with orthodontic treatment. The procedure stimulates the bone around your teeth, allowing them to move more quickly and with greater precision than traditional braces or aligners alone. Treatment time is typically reduced by around 50 percent.
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What PAOO involves

PAOO is a multi-stage treatment that requires both a surgical and an orthodontic component.

Assessment and treatment planning

Before anything else, a thorough clinical assessment is carried out, including your teeth, bite, bone structure, and periodontal health. This determines whether PAOO is indicated for your case.

The surgical procedure

A periodontal procedure is performed on the bone surrounding the teeth being moved. This typically involves a corticotomy (small, precise incisions in the bone) along with a bone grafting material. This is a surgical procedure performed under local anaesthesia.

Orthodontic treatment

Braces or aligners are placed following the procedure. Tooth movement occurs during the healing phase, which is where the efficiency gain comes from in appropriate cases.

Retention

As with all orthodontic treatment, retainers are required after treatment is complete to maintain the result.

Potential clinical outcomes in appropriate cases

In cases where PAOO is clinically indicated, the literature and clinical experience suggest it may offer:

  • Reduced treatment time normally 50% of the time required in traditional orthodontics
  • Enhanced expansion
  • More specific in terms of tooth movement and dentofacial aesthetics
  • Minimal discomfort
  • Improved post orthodontic stability
  • Reduced incidence of post orthodontic gum recessions
  • Increased net bone volume for supporting teeth and overlying facial soft tissue: fuller face and reduced aging.

Who PAOO may be appropriate for

PAOO is considered for a specific subset of adult orthodontic patients. It may be discussed as an option where:

  • There is moderate to severe crowding that presents particular clinical challenges
  • The case involves bone or expansion requirements that conventional orthodontics may not adequately address
  • A full clinical assessment indicates the patient is a suitable surgical candidate

Suitability is assessed on clinical grounds. If you are not a candidate, we will discuss what alternatives are appropriate for your situation.

PAOO at Designer Smiles

PAOO is offered at Designer Smiles under the care of Dr. Sarkis Nalbandian, Specialist Prosthodontist and Implant Surgeon. Accelerated orthodontics forms part of his specific clinical expertise, alongside piezo surgery, complex prosthodontics, and implantology.

Dr. Nalbandian completed his Bachelor of Dental Surgery in 1983 and holds postgraduate qualifications including M. Clin. Dent. (Prosth) from King’s College London and D. Clin. Dent. (Prosth) from the University of Sydney. He is a Fellow of the Royal Australasian College of Dental Surgeons and a contributor to postgraduate dental programs at King’s College London. He is also the founder and course director of the International College of Dental Practitioners.

All treatment decisions are made on clinical grounds, with full explanation of the options, risks, and alternatives provided at consultation.

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Case Study

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PAOO (Periodontally Accelerated Osteogenic Orthodontics)

Severe upper and lower crowding was a concern for Ms L.

Main concern was:

  • crowding severe maxillary/mandibular crowding.

In the past, this patient was advised extraction of all four premolar teeth (this was not an option for the patient preferring different less invasive approach.

MORE CASE STUDIES

What our Clients Say!

I've been a customer of Designer Smiles for over 20 years and I cannot say enough good things about them! From the moment you walk into the office, you are greeted with a warm and friendly atmosphere that immediately puts you at ease. The staff is knowledgeable, professional, and caring. They use the latest technology and take the time to explain everything. I highly recommend them!

Ken Baumli

Dr Sarkis is the maestro of cosmetic dentistry….for years I suffered with 2 slightly darker front teeth due to a childhood accident. I’ve had composite veneers before but nothing compared to the composite veneers Dr Sarkis did……now I feel so confident smiling again……Dr Sarkis I can’t thank you enough…

Monica McKenzie

Quite literally the best dentist I’ve been to in a lifetime. Dr Natasha Koelmeyer specifically is just a wonderfully kind and gentle Doctor. Must also mention that the head specialist here is also second to none. Their knowledge (goodness they know their stuff) their approach, their kind and gentle manner - my daughter actually enjoys going to the dentist. They’ve got a really considered patient centric mentality. I wouldn’t go anywhere else, every single person there including the reception staff is a star. Thank you Designer Smiles!

Michelle Lacasse

My journey with Dr Sarkis began about 10 years ago. I did not realise that I had lacked self confidence and shone away from "my true smile". Dr Sarkis was honest, reassuring and professional throughout my process and not only was he able to achieve that perfect smile but achieve same without compromising the health of my teeth and gums.The ongoing care at Designer Smiles is 5 star whether it is a routine check, clean minor or major dentistry. Thank you Dr Sarkis and also your team.

Christina Vergotis

I found Designer Smiles from one of their YouTube videos showcasing the Icon treatment to fix white spots on teeth. Dr. Sarkis Nalbandian's consultation provided me with a thorough plan and showed me how their practise could give me predicable results for my concerns. I knew I was in safe hands. I had Kristy Gupta perform both of my procedures and she was very professional and so kind. I am very happy with my results!

Winsome Kain

I cannot express how grateful I am for Sarkis and the team at Designer Smiles. Around 11 years ago my life changed when Sarkis first transformed my smile with composite veneers. This month, with my original teeth in tact I returned to have my composite veneers upgraded to porcelain. I was amazed that Sarkis and his team could do this without an injections, no pain and whilst still keeping my original teeth in tact. I absolutely love the result and I would highly recommend that anyone that is unhappy with their smile in any way, must visit designer smiles

Matt Williams

Started my treatment with the team at Designer Smiles in 2019. Had other dental treatments including Maxillofacial, expanders, straightening and gum grafting but out of all the procedures and surgeries Dr. Sarkis was the key as he was applying the ‘finishing product’ which included composite veneers. I am gobsmacked by the incredible job done. He talks the talk and definitely walks the walk. And his support team there are simply incredible and make you feel part of a family not just another dental clinic to take your money. Can not recommend highly enough. Customer for life here!!

Shaun Meader

Frequently Asked Questions

PAOO painful?

The procedure is carried out under local anaesthetic. Post-operative soreness and swelling are common in the days following surgery and are typically managed with pain relief as directed by your treating clinician.

In appropriate cases, treatment duration may be reduced compared to conventional orthodontics. However, total treatment time depends on the complexity of the case and cannot be guaranteed in advance.

As with any surgical procedure, PAOO carries potential risks including swelling, discomfort, and infection. These will be discussed in full at your consultation before any decision is made.

Designer Smiles offers a range of orthodontic treatments including metal braces, clear braces, lingual braces, and ClearCorrect. The appropriate option is recommended following assessment.

Get In Touch

(02) 9953 4189

Mon to Fri: 8.00AM-5.00PM
Sat-Sun: Closed

Address: 17 Gerard St, Cremorne, Sydney,NSW, 2090

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